与非O1和非O139 Vibrio cholerae Bacteremia相关的急性胆炎:一个病例报告
Yoshinori Takahashi1, Ryosuke Isshiki1, Hajime Sunagozaka2
1Department of General Medicine and Infectious Diseases, Japan Agricultural Cooperative (JA) Toyama Koseiren Takaoka Hospital, Takaoka, JPN.
Cureus
|September 2, 2025
概括
在免疫功能低下的患者中,非O1和非O139的振动性霍乱 (NOVC) 引起了细菌性急性胆炎. 这突显了NOVC菌株具有替代毒性因子的入侵潜力.
科学领域:
- 传染性疾病
- 微生物学
- 临床医学
背景情况:
- 急性胆道炎和细菌性病是严重的感染,通常与格拉姆阴性细菌有关.
- 霍乱病毒通常会导致霍乱,但非O1和非O139 (NOVC) 菌株可能会导致肠外感染.
研究的目的:
- 报告NOVC菌株引起的急性胆道炎与细菌性病例.
- 确定NOVC菌株的毒性基因的特征.
- 讨论对侵袭性NOVC感染的诊断和管理的影响.
主要方法:
- 一个76岁的男性患者的病例报告.
- 从血液培养物中分离和鉴定Vibrio cholerae.
- 分子分析检测毒性基因,包括霍乱毒素基因.
- 检查患者的病史和危险因素.
主要成果:
- 这位患者患有NOVC引起的急性胆道炎和细菌病,血清组为O120.
- NOVC菌株缺乏霍乱毒素基因,但具有其他毒性基因 (hlyA,rtxA,vscV2,vspD).
- 患者的危险因素包括全胃切除术,糖尿病和之前的胆道干预.
结论:
- 非-O1/非-O139 Vibrio cholerae可能导致严重的侵袭性感染,如胆管炎和细菌性病.
- 除了霍乱毒素之外的病毒性因素有助于NOVC菌株的致病性.
- 及时诊断,考虑到患者病史和适当的培养,对于管理侵入性NOVC感染至关重要,特别是在免疫受损的宿主中.
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